Affiliations: Department of Pediatrics, University of Alabama at
Birmingham, Birmingham, AL, USA
Note: [] Correspondence: Robert L. Schelonka, MD, 525 New Hillman
Building, 619 19th Street South, Birmingham, AL 35233, USA. Tel.: +1 205 987
6450; Fax: +1 205 934 3100; E-mail: rschelonka@peds.uab.edu
Abstract: The incidence of nosocomial septicemia is extremely common in
immature, newborn infants receiving intensive care. Developmental facets of
host defense, medical interventions, and the hospital environment contribute to
the septicemia rate exceeding 40% in extremely low birth weight infants. There
is growing evidence that multifaceted, collaborative quality improvement
measures may decrease infection rates; however, the effective implementation of
these measures requires introspection and detailed analysis of
hospital-specific infection control practices. Immune augmentation with human
milk has been shown to effectively reduce nosocomial infections. The efficacy
of pharmacologic agents such as polyclonal intravenous immune globulin and
colony stimulating factors to reduce nosocomial infections has been mixed.
Systemic antimicrobial prophylaxis may decrease staphylococcal and Candida spp
infection rates in hospitalized infants, but this therapy carries the risks of
alteration in host microbial flora as well as the development of antimicrobial
resistance. Specifically targeted immunotherapy with hyper-immunoglobulin
preparations, monoclonal antibodies and probiotics are currently being
investigated and may become effective tools to reduce nosocomial infections in
the future.
